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ZeitschriftenaufsatzAccess status: Open Access ,
Profiling disease experience in patients living with brain aneurysms by analyzing multimodal clinical data and quality of life measures
(2025) Reder, Sebastian R.; Hardt, Jochen; Brockmann, Marc A.; Brockmann, Carolin; Kim, Suam; Kawulycz, Melina; Schulz, Marie; Kantelhardt, Sven Rainer; Petrowski, Katja; Fischbeck, Sabine
To explore the mental and physical health (MH, PH) on individuals living with brain aneurysms and to profile their differences in disease experience. In N = 111 patients the Short Form 36 Health Survey (SF-36) was assessed via an online survey; Supplementary data included angiography and magnetic resonance imaging (MRI) findings (including AI-based brain Lesion Volume analyses in ml, or LV). Correlation and regression analyses were conducted (including biological sex, age, overall brain LV, PH, MH). Disease profiles were determined using principal component analysis. Compared to the German normative cohort, patients exhibited overall lower SF-36 scores. In regression analyses, the DW was predictable by PH (β = 0.345) and MH (β=-0.646; R = 0.557; p < 0.001). Vasospasm severity correlated significantly with LV (r = 0.242, p = 0.043), MH (r=-0.321, p = 0.043), and PH (r=-0.372, p = 0.028). Higher LV were associated with poorer PH (r=-0.502, p = 0.001), unlike MH (p > 0.05). Main disease profiles were identified: (1) those with increased LV post-rupture (high DW); (2) older individuals with stable aneurysms (low DW); (3) revealing a sex disparity in QoL despite similar vasospasm severity; and 4), focused on chronic pain and its impact on daily tasks. Two sub-profiles highlighted trauma-induced impairments, functional disabilities from LV, and persistent anxiety. Reduced thalamic and pallidal volumes were linked to low QoL following subarachnoid hemorrhage. MH has a greater impact on life quality compared to physical disabilities, leading to prolonged DW. A singular physical impairment was rather atypical for a perceived worse outcome. Patient profiles revealed that clinical history, sex, psychological stress, and pain each contribute uniquely to QoL and work capacity. Prioritizing MH in assessing workability and rehabilitation is crucial for survivors’ long-term outcome.
ZeitschriftenaufsatzAccess status: Open Access ,
LI-RADS : concordance between energy-integrating computed tomography, photon-counting detector computed tomography and magnetic resonance imaging
(2025) Müller, Lukas; Jorg, Tobias; Stoehr, Fabian; Grunz, Jan-Peter; Graafen, Dirk; Halfmann, Moritz C.; Huflage, Henner; Foerster, Friedrich; Mittler, Jens; Pinto dos Santos, Daniel; Bäuerle, Tobias; Kloeckner, Roman; Emrich, Tilman
Background Photon-counting detector CT (PCD-CT) offers technical advantages over energy-integrating detector CT (EID-CT) for liver imaging. However, it is unclear whether these translate into clinical improvements regarding the classification of suspicious liver lesions using the Liver Imaging Reporting and Data System (LI-RADS). This study compared the intra- and intermodal agreement of EID-CT and PCD-CT with Magnetic resonance imaging (MRI) for liver lesion classification. Methods This retrospective study included patients who underwent EID-CT or PCD-CT and MRI within 30 days between 02/2023 and 01/2024. Three board-certified radiologists assessed LI-RADS classification and presence of LI-RADS major features. Fleiss’ Kappa and intraclass correlation coefficients (ICC) were used to evaluate rater agreement. Results Sixty-eight lesions in 26 patients (mean age 65.0 ± 14.2 years, 19 [73.1%] male) were analyzed. Intramodal inter-rater agreement for LI-RADS classification was 0.88 (0.62–0.88) for EID-CT, 0.90 (0.83–0.94) for PCD-CT, and 0.87 (0.81–0.91) for MRI. Agreement in PCD-CT was substantial for all LI-RADS major features, whereas in EID-CT only for washout. Intermodal agreement between CT and MRI ranged from 0.67 to 0.72. Final intermodal LI-RADS classification agreement was higher for PCD-CT (0.72–0.85) than EID-CT (0.52–0.64). Conclusions PCD-CT demonstrated higher intermodal and intramodal agreement for LI-RADS classification and major features than EID-CT. Additionally, PCD-CT shows significantly higher intramodal and inter-rater agreement for LI-RADS classification and greater concordance with MRI compared to EID-CT, reaching substantial to almost perfect agreement. These results suggest a potential benefit of PCD-CT in the management and treatment decision-making of HCC.
ZeitschriftenaufsatzAccess status: Open Access ,
Robotic placement of experimental prototypes for wireless gastric electrical stimulation
(2025) Schiemer, Jonas F.; Stumm, Karen; Olsommer, Yves; Lang, Hauke; Baumgart, Nadine; Baumgart, Jan; Kneist, Werner
Introduction Gastric electrical stimulation (GES) is an effective treatment for gastroparesis. However, the available devices are equipped with bulky batteries that need to be replaced regularly by surgery. Methods Our new implantable system consists of only 6 passive components in addition to a diode and does not require a battery. Two acute porcine experiments were carried out with a robotic surgical system for placement of the prototypes. The stimulation parameters were set with an extracorporeal unit and GES was performed. The recorded electromyography (EMG) signal was subjected to a multiresolution analysis. Results The robot-assisted placement of the prototypes was successful. The inductive energy transfer was confirmed to be functional and EMG analysis revealed changes in gastric electrical activity. Conclusions Further technological and rapid regulatory solutions are being sought in order to start a clinical trial with the next generation devices in the near future.